Starting and Switching Antiretroviral Therapy in Children

First-line PI- and NNRTI-based therapies offer equivalent virologic efficacy in children without prior exposure to NNRTIs. However, when failure occurs, an immediate switch is necessary for those on NNRTIs.

For young HIV-infected children previously exposed to nonnucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitor (PI)-based therapy has been shown to be superior to NNRTI-based therapy (JW AIDS Clin Care Oct 18 2010). Whether this is also true for older children (age >3 years) without NNRTI exposure is unclear.

In the PENPACT-1 trial, investigators compared outcomes between NNRTI- and PI-based therapies among 266 treatment-naive children (median age, 6.5 years) in Europe, South America, and North America. Only 2% had been exposed to single-dose nevirapine at birth. The children were randomized to receive two nucleoside reverse transcriptase inhibitors (NRTIs) plus an NNRTI or a PI; the specific drugs were selected by their t…

Reviewing Author

Holly Rawizza, MD

Starting and Switching Antiretroviral Therapy in Children

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Reviewing Author